Mass. To Cut Payments to Docs & Hospitals

Massachusetts’s universal health-care plan is turning out to be more expensive than predicted. Now the state is looking at cutting payments to docs and hospitals next year to make ends meet.

That fiscal reaction, which some critics of the plan warned about, sends a stark message to those of us in the other 49 states. Massachusetts has become something of a model for the national plans proposed by Hillary Clinton and John Edwards, among others.

The state requires everybody to buy health insurance. A subsidized health plan offered to the poor as part of the program has proved more popular than expected, and that’s helping to push costs 20% over what the state had budgeted. The tab could run $619 million for the current fiscal year, $147 million over budget, the Boston Globe reports.

Now the board that oversees the plans has approved cuts of 3% to 5% in reimbursements for to health-care providers caring for those in the subsidized plan. The article suggests the cuts will bring reimbursement in line with Medicaid.

The board postponed a decision on a more controversial issue: whether to raise co-pays and other out-of-pocket costs for those whose income is above the poverty level. Doctor visits, prescription drugs and hospital care cost “much less” for those with subsidized insurance than for those with private insurance, according to the article.

Comments (5 of 20)

I am glad Medicare is finally waking up and mabe there will be less errors and less MRSA in hosptal

10:29 am December 17, 2007

John wrote :

Crowd out? What crowd out?

9:34 am December 17, 2007

Also Anonymous Again wrote :

I dare any of the politicians running for President to say: We need to start rationing health care in public programs the way it's done in managed care.
Too many procedures and tests are pushed by providers (scared of being sued or incentivized to produce volume) onto an ignorant public. We need tort reform AND public health education (there is a Health Literacy and Education bill pending in Congress right now) AND 1 nationally interconnected medical records system AND a stratified health care plan. If you are poor, you qualify for the very basic, 'emergency care coverage hospital only' layer of care without charge. Any additional layer of services will require additional monthly premiums/ co-pays. (Like any other insurance). Based on one's genetic, racial and familial make-up, certain people are more prone to certain diseases. Additional coverages can be disease-based or service based (outpatient care, preventive care) and packages can be purchased in that manner. Further encouraging people to keep their heads in the sand about their own health will only lead to further reckless health choices (obesity, uncontrolled diabetic episodes, heart disease, etc) and runaway health care spending. Everyone is responsible for keeping costs down- patients, suppliers, providers, insurers, government, taxpayers and the legal system (tort reform!) The era of 'not me' needs to come to a close.

8:56 am December 17, 2007

John C wrote :

In response to run4gold. AND just how would you get people to "be held individually accountable for doing their part to reduce costs. This includes but is not limited to incorporating physically activity and healthful nutrition healthful nutrition in their daily lives to reduce their risk for chronic diseases like heart disease, stroke, cancer and diabetes."

You do it through education AND insurance plan beneficiary rates that are commenserate with costs.

8:05 am December 17, 2007

run4gold wrote :

It is time for all Americans to get off the couch, take a look in the mirror and become personally responsible for their health. All legislators and presidential hopefuls should be focused on a comprehensive overhaul of our health system. It should be prevention centered, not disease centered. The country should be demanding that resources are shifted to preventive health services. Americans should be held individually accountable for doing their part to reduce costs. This includes but is not limited to incorporating physically activity and healthful nutrition healthful nutrition in their daily lives to reduce their risk for chronic diseases like heart disease, stroke, cancer and diabetes. It is these very diseases that are now affecting the nations children and adults and will continue to "break the bank".
When costs continue to escalate, the answer is not to decrease reimbursement to providers but to stop the rate of illness through primary prevention.